Updating the classification and routine diagnosis of NSAID hypersensitivity reactions: A WAO Statement.

Hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAIDs) have been classified as immediate (or acute) and delayed. Immediate reactions can be further classified into 4 clinical types: NSAID-exacerbated respiratory disease (N-ERD), NSAID-exacerbated cutaneous disease (NECD), NSAID-induced urticaria/angioedema (NIUA), and single NSAID-induced urticaria/angioedema/anaphylaxis (SNIUAA). Specifically, the NIUA type references reactions to ≥2 NSAIDs belonging to different chemical groups, involving urticaria and/or angioedema in patients with no underlying chronic spontaneous urticaria.

Recurrences of anaphylaxis: trends and risk factors.

Purpose Of Review: Recurrences of anaphylaxis is a concern due to its unpredictability and long-term burden to patients and healthcare systems. This review examines recurrence rates, associated risk factors, and gaps in current knowledge to guide improved clinical management.

Recent Findings: From 1240 initial records, 11 studies fulfilled the inclusion criteria of our systematic review.

Development of a Risk-Stratification Tool for Nonsteroidal Anti-Inflammatory Drug Hypersensitivity on a Large Cohort.

Background: A risk stratification tool for nonsteroidal anti-inflammatory drugs (NSAIDs) hypersensitivity is currently lacking.

Objective: To develop and validate a risk stratification tool for NSAID hypersensitivity.

Methods: We conducted a retrospective study of subjects presenting between February 2001 and December 2020 at the Allergy Unit of the University Hospital of Montpellier, with a history of hypersensitivity to NSAIDs.

Exploring the pathogenesis and clinical implications of asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO): a narrative review.

The complexity and diversity of the immune response in patients with asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap present significant challenges for disease management. Relying on a limited number of biomarkers and clinical data is insufficient to fully reveal the immunopathogenesis of these diseases. However, technologies such as cell analysis, cytokine investigation, and nucleic acid sequencing have provided new insights into the underlying mechanisms of these diseases, leading to the discovery of several biomarkers-including cell degranulation, cell function, secreted cytokines, and single nucleotide polymorphisms-that have potential clinical implications.

Anaphylaxis severity grade, during oral food challenges, assessed by five different classifications.

Background: While the definition of anaphylaxis is clear, its grade of severity remains a subject of debate. The objective of this study was to evaluate the possible discrepancies in the severity scoring system for anaphylaxis in patients with a positive food challenge (OFC), differentiating anaphylactic and non-anaphylactic reactions, using the WHO for the 11th version of the International Classification of Diseases (ICD-11) as the main reference.

Methods: We conducted a retrospective observational study at the University Hospital of Montpellier, France, including patients with a positive food OFC between 2018 and 2022.

National expert consensus on the management of antibiotic prophylaxis in surgical patients with a penicillin allergy label based on the Delphi method.

Background: Patients with a penicillin allergy label have an increased risk of surgical site infection. Although a decision tree was published in 2019 to define which patients could benefit from direct cephalosporin use in the perioperative setting, this strategy remains unvalidated. This consensus statement aimed to adapt it based on an expert consensus to cover persisting caveats and to adapt it to an environment with poor allergist resources.

Penicillin allergy management strategies relevant for clinical practice - a narrative review.

Penicillin allergy is the most commonly reported drug allergy, with prevalence rates ranging from 6% to 31% across various populations and geographic areas. The penicillin allergy label is linked to higher mortality and morbidity rates, extended hospital stays, increased readmission rates, and a greater reliance on second-line antibiotics. Research indicates that nearly 99% of those labeled as penicillin-allergic can tolerate the drug.

Correction to "Impact of liquid sublingual immunotherapy on asthma onset and progression in patients with allergic rhinitis: a nationwide population-based study (EfficAPSI study)" [The Lancet Regional Health - Europe 41 (2024) 100915].

[This corrects the article DOI: 10.1016/j.lanepe.

Who is at-risk for severe anaphylaxis in France?

Background: The understanding of risk factors related to severe anaphylaxis is key to implementing prevention strategies. We present the first French population-based nine-year anaphylaxis hospitalization study evaluating specific trends and factors related to severe anaphylaxis (SA), to support identification of phenotypes at-risk.

Methods: This study used descriptive data from the French hospitalization database for the years 2012-2021, and included all patients hospitalized with anaphylaxis using International Classification of Diseases (ICD)-10 codes listed as a primary diagnosis.

Allergic and hypersensitivity condition in the International Patients' Summary (IPS) standard: The need of updates through the International Classification of Diseases (ICD)-11.

In 2010, the United States Human and Health Services (US HHS) and the European Union's (EU) Directorate General for Communications Networks, Content and Technology signed a memorandum of understanding to stimulate cooperation surrounding health-related information communications technology. The key project that emerged from this agreement is the (IPS), intended to provide succinct clinically relevant patient summaries, which are generalizable and condition-independent, that can be readily used by all clinicians for the care of patients. Although allergies are included in the main information required by the IPS library and framework, it is misrepresented which leads to underdiagnosis or misdiagnosis of patients suffering from allergic and hypersensitivity conditions (A/H).

Skin Test Reactivity Patterns in Patients Allergic to Iodinated Contrast Media: A Refined View.

Background: Two-dimensional (2D) classifications of iodinated contrast media (ICM) are insufficient to explain the observed skin test (ST) reactivity patterns in patients with drug hypersensitivity reactions (DHRs) to ICM.

Objective: To refine the current view on allergic DHRs to ICM by analyzing ST reactivity patterns in patients with previous reactions to ICM.

Methods: Patients with a history of DHR to ICM and positive STs, who presented at the University Hospital of Montpellier between 2004 and 2022, were included in the study.

Drug allergy awareness and perspectives with the implementation of the International Classification of Diseases-11.

Purpose Of Review: To understand the current global scale of drug hypersensitivity (DH) and drug allergy (DA), and to identify possible strategies to increase the accuracy of epidemiological data.

Recent Findings: Global patterns of DH/DA seem to be changing and increasing worldwide, but there are still great challenges in capturing quality DH/DA mortality and morbidity statistics (MMS). DH/DA MMS may gain new perspectives with the global implementation of the International Classification of Diseases (ICD)-11.

The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study.

Background: Environmental and behavioral factors are responsible for 12.6 million deaths annually and contribute to 25% of deaths and chronic diseases worldwide. Through the One Health initiative, the World Health Organization and other international health organizations plan to improve these indicators to create healthier environments by 2030.

Impact of liquid sublingual immunotherapy on asthma onset and progression in patients with allergic rhinitis: a nationwide population-based study (EfficAPSI study).

Background: The only disease-modifying treatment currently available for allergic rhinitis (AR) is allergen immunotherapy (AIT). The main objective of the EfficAPSI real-world study (RWS) was to evaluate the impact of liquid sublingual immunotherapy (SLIT-liquid) on asthma onset and evolution in AR patients.

Methods: An analysis with propensity score weighting was performed using the EfficAPSI cohort, comparing patients dispensed SLIT-liquid with patients dispensed AR symptomatic medication with no history of AIT (controls).

Respiratory allergic diseases and allergen immunotherapy: A French patient survey before and during the COVID-19 pandemic.

Background: The COVID-19 pandemic brought unprecedented global disruption to both healthcare providers and patients with respiratory allergies. There are limited real-life data on the impact of the COVID-19 pandemic on the risk perception of patients with allergy treated with allergen immunotherapy (AIT).

Objective: To understand the risk perception of allergic patients treated with sublingual immunotherapy (SLIT) before and during the pandemic, and their attitudes towards COVID-19 infection and vaccination.

Efficacy of 300 IR house dust mite immunotherapy as a function of disease activity: Tertile analysis in clinical trials.

Background: The symptoms of house dust mite (HDM)-induced allergic rhinitis (AR) vary with changes in exposure related to the weather or the domestic environment. In allergen immunotherapy (AIT) studies, a certain level of AR disease activity is necessary to demonstrate treatment efficacy; the latter can be underestimated if a substantial proportion of the patient population is weakly symptomatic.

Objective: To better estimate the real treatment effect of a HDM sublingual AIT (SLIT) tablet, we analysed the results of natural field studies in detail by applying a tertile approach.

Association between physical activity over a 10-year period and current insomnia symptoms, sleep duration and daytime sleepiness: a European population-based study.

Objectives: To explore the relationship between physical activity over a 10-year period and current symptoms of insomnia, daytime sleepiness and estimated sleep duration in adults aged 39-67.

Design: Population-based, multicentre cohort study.

Setting: 21 centres in nine European countries.